Provider Demographics
NPI:1710372206
Name:PALMER, KELSEY ERIN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KELSEY
Middle Name:ERIN
Last Name:PALMER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2204 QUINN HAVEN DR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-1193
Mailing Address - Country:US
Mailing Address - Phone:406-690-0590
Mailing Address - Fax:
Practice Address - Street 1:30 S 2000 E
Practice Address - Street 2:4TH FLOOR, #2F
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84112-5820
Practice Address - Country:US
Practice Address - Phone:406-690-0590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-01
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9047356-1701183500000X
MT25433183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist